An apparatus for tracking movement of a foreign object within a subject has an X-ray fluoroscopic system with an X-ray detector and an ultrasound system that has a probe with a position sensor. A display is configured to display a static X-ray image acquired by the X-ray fluoroscopic system and a real-time ultrasound image acquired by the ultrasound system. The X-ray image and the ultrasound image each display at least a portion of the foreign object and at least a portion of surrounding area. A tracking module is configured to track movement of the foreign object within the ultrasound image and the display is further configured to display an indication of the movement of the foreign object on the X-ray image.